Orthognathic Surgery Postoperative Instructions

These postoperative instructions are to be used as a guideline to help make your postoperative course uneventful and answer questions you or your caregivers might have. You have just had a major surgery performed and not all patients respond the same. If you have questions that these instructions do no cover, please call the office to speak to one of our surgeons. If you think you are having a complication please call immediately.

Postoperative Visits: After discharge from the hospital a postoperative visit should scheduled usually within two to four days.

Diet: Immediately after surgery you will be on a liquid diet. This can be advanced to a pureed diet (puddings, applesauce, oatmeal, or anything blenderized) usually by the second postoperative day. By the end of the first week you can usually be advanced to a very soft diet (pastas, baked fish, cooked vegetables). Your surgeon will discuss the advancement of your particular diet during your postoperative office visits. Please see booklet enclosed tilted, Your Diet.

It is extremely important to maintain a healthy diet. A high calorie, high protein diet is recommended, with frequent meals and snacks. Nutritional supplements (ensure and carnation instant breakfast) are an excellent addition to your diet.

Activity: Immediately after surgery you will feel lethargic. This is normal and is anticipated after any general anesthesia and major surgery where you may have significant blood loss. If you have had upper and lower jaw surgery performed it will take approximately two weeks to feel your strength returning toward normal. If you have had upper or lower jaw surgery performed you will feel your strength returning toward normal usually by the end of the first week. Your activity for the first week should be limited to normal non-strenuous activates. If you are requiring narcotic pain medications for control of discomfort you should not be driving a car or working with any dangerous equipment. The best rule of thumb is to listen to your body: when you feel good perform activities and when you feel tired then rest.

Medication: Upon discharge from the hospital you will usually be given prescriptions for an antibiotic and a narcotic pain medicine. Please use these as instructed! If you have questions about the medicines or have a reaction to one the medicines or have a reaction to one the medicines please call the office.

Oral Hygiene: It is important to maintain excellent oral hygiene. After any meal, even full liquids; please rinse your mouth with warm salt water (1/4 tsp salt to six oz. of water). Once you get home from the hospital you can start brushing your teeth. Use a soft pediatric toothbrush and only brush the teeth and braces. At first you probably will not be able to open wide enough to brush the tops or inside portion of your teeth. Always use fluoride toothpaste.

A water-pik is a good adjunct to your oral hygiene regime. Do not start this until the fourth postoperative day. Set the machine on the lowest setting and aim the water stream only at your braces and teeth. Please see pamphlets in folder.

Incisions: If you had lower jaw surgery you will have two small incisions at the angle of your jaw. Please clean theses incisions twice a day with a solution of ½ hydrogen peroxide and ½ sterile water. A Q-tip can be used to gently clean around the incision. After cleaning please place a small amount of an antibiotic ointment over the incision.

Lips: Your lips and surrounding skin may start to peel. Avoid peeling the dead skin as it may be attached to deeper tissues. You can gently remove the dead skin if it rubs off after soaking the area with a warm washcloth. Keep your lips moist with lip balm (Chapstick, Blistex and Carmex).

Elastics: You will probably have guiding elastics attached to your braces. These are important to help retrain the movement of your jaws. You will not hurt anything if you try to open though it will probably feel “tight”. If your elastics break on one side, removed the elastics on the opposite side to prevent uneven pulling and call your surgeon. Usually you can wait until office hours for these to be replaced. After the first week you will be taught how to place the elastics yourself and can begin removing the elastics at mealtime to make eating easier.

Swelling: Every patient will experience some degree of swelling. Ice placed on the cheeks will aid in keeping the swelling down. Ice is used for the first 48 hours and then moist heat can be used. Sometimes even after 48 hours the ice packs will feel good on your cheeks and you can alternate hot and cold packs.

Numbness: Nearly all patients will experience numbness. This resolves differently for each person. Sometimes it may take months for the feeling in your lips to begin to return.

Remember, each person responds differently to surgery and you may have special circumstances that may necessitate deviation from our guidelines. Your surgeon will discuss any modifications of your postoperative course but should you have any questions of concerns please call either our Denver Office (303) 758-6850 or Thornton Office 720-453-2144 for clarification.